Female genital mutilation (FGM) is also known as female circumcision or cutting. The World Health Organization (WHO) defines FGM as procedures that include the partial or total removal of the external female genital organs for cultural or other non-therapeutic reasons.
FGM is illegal in the UK. However, it is estimated that 20,000 girls under the age of 15 are at risk of FGM and over 66,000 women and girls living in Britain have experienced it. The procedure can have long-lasting physical and psychological effects, such as chronic pain, infection, sexual difficulties and complications in pregnancy and childbirth, as well as a number of mental health problems. It is therefore important that women and girls receive the correct types of care within the NHS. Although some sexual health services may be able to advise you about FGM, in most cases they will need to refer you to a more specialised NHS FGM clinic.
Some women and girls who have had FGM can find it difficult to access NHS services at first. They often worry that the doctors and nurses or other NHS staff might not understand what FGM is, or their situation or cultural background. Although there is no medical need for FGM and despite the serious health effects this procedure has on women, it is still seen as an important rite of passage in many cultures.
NHS staff will not judge you and will treat you with respect. They will do their best to treat the medical problems caused by FGM. However, they do have a legal duty to protect children and will therefore take action if they think a young girl may be at risk of FGM.
As with sexual health services, most GP’s will not able to deal fully with the health consequences of FGM themselves and will usually refer you on to a more specialised NHS FGM clinic.
Specialist FGM clinics
There are several FGM clinics available in London and in many large UK cities. Some are linked to an antenatal clinic, while others may be within a community clinic or GP surgery. Download a list of all available FGM clinics (PDF, 430kb), including their contact details.
All of these clinics are NHS clinics and therefore free of charge. Most clinics are run by specially trained doctors, nurses or midwives who can understand why you have had FGM and are able to treat most of the medical problems caused by it.
How to access an FGM clinic
If you wish to go to one of the clinics, you should check if you need a GP referral, as most clinics encourage and support self-referrals. If you are pregnant, your midwife may be able to refer you. Some clinics will only see you if you live in an area nearby. Contact the clinic you want to see in advance to see what their requirements are. A list of clinics, including their contact details, can be found below.
What services are available?
Services will vary between clinics. Most clinics will be able to see and examine you. In some FGM procedures, a woman’s vagina will have been closed and a small operation is needed to re-open it (also called reversal or deinfibulation). This will allow the women to have sex again and will also make childbirth safer for both the woman and the baby. If you need a procedure to open the vagina, the clinic can arrange this. Other services may include:
It’s always best to check with the clinic what’s on offer before booking an appointment. The clinic staff may also be able to tell you who would provide a service if they can’t offer it themselves.
What happens at the appointment?
What FGM service you visit and the type of examination you’ll receive depends on your personal situation and medical needs. Usually, you would talk to a doctor or nurse at the clinic. With your permission, they will then examine the genital area to see what type of FGM has been performed and what can be done to help.
All consultations are confidential. This means that your personal details and any information about the tests or treatments you have received will not be shared with anyone outside the clinic without your permission.
If you are under 18 years of age, your details will still be treated confidentially. However, doctors and nurses are legally required to inform authorities such as children’s services or police if they suspect you are at risk of having FGM or believe you’ve had FGM already. If this is the case, it will be discussed with you during your visit.
Talking to a stranger can be difficult. You can always bring a friend or another trusted person to your consultation. They can offer you support, and could also help you ask the right questions, or help you to decide on a treatment. Staff may also encourage you to talk to a trusted adult such as a teacher or school nurse.
If English is not your first language, you should ask for an interpreter in advance. All clinics can arrange some form of interpreter. If you cannot make arrangements in advance, a telephone interpreter may be consulted.
Alison Byrne, Birmingham Heartlands Hospital, African Women’s clinic – 07817 534274
- Summer Letter from Under Secretary of State
- Commissioning services to support women and girls with FGM
- FGM safeguarding
- FGM Multi-Agency Practice Guidelines
- FGM Prevention online resources